Background: Refractory/relapsed acute leukemia has always been a challenging problem for hematologist. Over the past decade emphasis has been made in the development of regimens containing fludarabine, combined with cytosine arabinoside for the treatment of refractory/relapsed acute leukemias. The aim of this study is to evaluate the efficacy and toxicity of the combination of fludarabine, high dose cytarabine, and granulocyte colony stimulating factor in refractory relapsed cases of acute leukaemia,
Methods: a prospective study is being conducted at the national center of hematology and hematology unit /Baghdad teaching hospital from July 2008 to July 2010.Twenty Patients with refractory/relapsed acute leukemia were treated with fludarabine 30mg/m2 and cytosine arabinoside (AraC) 2 g/m2 for 5 days, and granulocyte colony stimulating factor G-CSF 300 microgram/day from day 0 till neutrophil recovery (ANC >1.0 x 109/l).Response was evaluated by bone marrow examination on day 30-post chemotherapy.
Results: Patients included were refractory acute lymphoblastic leukemia (ALL) (n=5), relapsed ALL (n=4), refractory acute myeloid leukemia (AML) (n=8), relapsed AML (n=3). Complete remission (CR) was achieved in 9(45%) patients, 3 (15%) patients got partial remission. Three (15%) patients died of post chemotherapy complications and 5(25%) patient failed to achieve remission. Major complications encountered were: anemia, fever, bleeding, mucositis and bacterial infections.
Conclusion: FLAG protocol is well tolerated and effective regimen in relapsed / refractory acute leukemias. The toxicity is acceptable, enabling most patients to receive further treatment, including transplantation procedures
<p>The demand for internet applications has increased rapidly. Providing quality of service (QoS) requirements for varied internet application is a challenging task. One important factor that is significantly affected on the QoS service is the transport layer. The transport layer provides end-to-end data transmission across a network. Currently, the most common transport protocols used by internet application are TCP (Transmission Control Protocol) and UDP (User Datagram Protocol). Also, there are recent transport protocols such as DCCP (data congestion control protocol), SCTP (stream congestion transmission protocol), and TFRC (TCP-friendly rate control), which are in the standardization process of Internet Engineering Task
... Show MoreThis research aimed to predict the permanent deformation (rutting) in conventional and rubberized asphalt mixes under repeated load conditions using the Finite Element Method (FEM). A three-dimensional (3D) model was developed to simulate the Wheel Track Testing (WTT) loading. The study was conducted using the Abaqus/Standard finite element software. The pavement slab was simulated using a nonlinear creep (time-hardening) model at 40°C. The responses of the viscoplastic model under the influence of the trapezoidal amplitude of moving wheel loadings were determined for different speeds and numbers of cycles. The results indicated that a wheel speed increase from 0.5Km/h to 1.0Km/h decreased the rut depth by about 22% and 24% in conv
... Show MoreBackground: low back pain is one of the most common public health problems and of the most common musculoskeletal complaint. Many risk factors have been considered for developing low back pain include smoking, obesity and sedentary lifestyle.
Aim of study: To evaluate smoking, obesity, and sedentary lifestyle associations with low back pain in young adults aged (18 – 39 years).
Methods: a comparative cross sectional study for young adults aged 18 – 39 years, participants with low back pain as a symptom constitutes the first group, others free of this symptom considered as the control group. Age and gender matched in both groups. Smoking, obesity and sedentary life sty
... Show MoreEngineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
... Show MoreFine aggregates used for concrete works in Sulaymaniyah city frequently fail to meet the standard requirements for gradation and fineness modulus in cement concrete. This paper aims to critically evaluate gradation, fineness modulus, and clay contents of various natural sands produced and used for concrete work in the region. Sixteen field sand samples were collected from various sites in Darbandikhan (5 samples), Qalat Dizah (5 samples), Koysinjaq (5 samples), and Piramagroon (1 sample) confirming to ASTM D75. The field samples were parted into test specimens based on ASTM C702. Then, sieve analysis was carried out on the oven-dry test specimens in compliance with ASTM C136. The test results of fine aggregates wer
... Show MoreGroundwater quality deterioration due to anthropogenic natural activities and its immense utilization in various sectors is considered a great concern. The aim of this study is to determine the groundwater quality parameters at various sources in and around Dhaka city and compare them with Bangladesh drinking water standards. In this study, six groundwater quality parameters (pH, DO, COD, TS, TDS, and arsenic) and ten groundwater samples are analyzed to determine the water quality. The collected samples have maximum and minimum pH values of 6.9 and 6.4, respectively. Maximum and minimum DO values are 0.3 and 0.1 mg/L, respectively. The arsenic concentration is 0 mg/L for all collected groundwater samples. The maximum and minimum COD
... Show MoreAlthough cinema is moving towards art, it has dealt with the character since the beginning of the discovery of cinematic art in films such as (Doctor Caligari's cabin) and most German expressive films in the third decade of the twentieth century, but the interest of cinema is growing in the estranged human personality, meaning that this character It lives by its alienation from the environment and society that surrounds it, because our present days have witnessed on the material and moral level more social breakdowns such as wars and disasters, and the sharp contradiction in the social and economic level of people themselves or between different societies, or between the individual and his community, and new social relations have increas
... Show MoreBackground: Otitis media with effusion is a common and important pediatric clinical problem; it is the leading cause of hearing impairment in children. Medical treatment remains controversial. Aim: To evaluate the usefulness of using topical nasal steroids in the treatment of otitis media with effusion. Patients and Methods: Between November 2019 and October 2022, a prospective controlled clinical study was carried out in the department of otolaryngology at Al-Jerrahat Teaching Hospital in Medical City, Baghdad, Iraq. This study comprised 40 patients with bilateral otitis media with effusion (23 males, 17 females). Two groups were created for the patients. Patients in group A (20 patients) were treated with mometasone furoate nasal spra
... Show MoreReintervention after balloon angioplasty is often considered inevitable in children with coarctation of the aorta (COA). The present study aimed to evaluate predictors of re-intervention after balloon angioplasty for COA, with the goal of identifying patient and procedural characteristics that may influence long-term outcomes